Measuring pathology using the PANSS across diagnoses: Inconsistency of the positive symptom domain across schizophrenia, schizoaffective, and bipolar disorder.
Measuring pathology using the PANSS across diagnoses: Inconsistency of the positive symptom domain across schizophrenia, schizoaffective, and bipolar disorder.
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DOI：
10.1016/j.psychres.2017.08.009
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发表时间：
2017-12
影响因子：
11.3
通讯作者：
Bilder RM
中科院分区：
文献类型：
--
作者：
Anderson AE;Mansolf M;Reise SP;Savitz A;Salvadore G;Li Q;Bilder RM
虽然阳性和阴性症状量表（PANSS）是为精神分裂症（SZ）开发的，但抗精神病药物试验也使用PANSS来测量双相（BP）和双情感（SA）障碍的症状变化，超出了其最初的适应症。如果PANSS测量的维度在诊断中不同，则相同药物条件的相同评分变化可能具有不同的含义，这取决于正在研究的组。在这里，我们评估了PANSS中的因子结构是否在精神分裂症（n = 3647）、双相情感障碍（n = 858）和双相情感障碍（n = 592）中一致。沿着与一致性系数，汉考克的H，和Jaccard指数，我们使用目标旋转和统计检验的基础上验证性因素模型的不变性。我们发现由30项PANSS测量的五个症状维度并不能很好地推广到双相情感障碍和双相情感障碍。一个模型的基础上的18项版本的PANSS概括更好地跨越SZ和BP组，但仍然存在重大问题，概括的一些因素，SA样本。精神分裂症和双相情感障碍在因子结构上的相似性大于精神分裂症和情感障碍。焦虑/抑郁因素是最一致的疾病，而积极的因素是最不一致的。
Although the Positive and Negative Syndrome Scale (PANSS) was developed for use in schizophrenia (SZ), antipsychotic drug trials use the PANSS to measure symptom change also for bipolar (BP) and schizoaffective (SA) disorder, extending beyond its original indications. If the dimensions measured by the PANSS are different across diagnoses, then the same score change for the same drug condition may have different meanings depending on which group is being studied. Here, we evaluated whether the factor structure in the PANSS was consistent across schizophrenia (n = 3647), bipolar disorder (n = 858), and schizoaffective disorder (n = 592). Along with congruency coefficients, Hancock's H, and Jaccard indices, we used target rotations and statistical tests of invariance based on confirmatory factor models. We found the five symptom dimensions measured by the 30-item PANSS did not generalize well to schizoaffective and bipolar disorders. A model based on an 18-item version of the PANSS generalized better across SZ and BP groups, but significant problems remained in generalizing some of the factors to the SA sample. Schizophrenia and bipolar disorder showed greater similarity in factor structure than did schizophrenia and schizoaffective disorder. The Anxiety/Depression factor was the most consistent across disorders, while the Positive factor was the least consistent.
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